Surgical pathology of the parietal pericardium: A study of 344 cases (1993-1999)
Surgical pathology of the parietal pericardium: A study of 344 cases (1993-1999)
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DOI：
10.1016/s1054-8807(01)00076-x
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发表时间：
2001-07-01
影响因子：
3.7
通讯作者：
Danielson, GK
中科院分区：
文献类型：
--
作者：
Oh, KY;Shimizu, M;Danielson, GK
手术切除壁层心包344例，年龄1 ~ 87岁（平均55岁），男性64%。心包疾病的原因包括肿瘤性（33%）、特发性（30%）、医源性（23%）和其他（14%）。心包缩窄（第1组）代表了最大的组（143例，76%为男性）。最大心包厚度为1-17 mm（平均4 mm）。96%发生纤维化增厚。慢性淋巴浆细胞性炎症影响73%（97%为轻度或中度）。钙化不常见（肉眼观察28%，显微镜下观察8%），肉芽肿罕见（4%，无结核性）。49%的狭窄是特发性的，41%是医源性的（心包切开术后或放疗后）。肿瘤和囊肿（第2组）代表第二大组（96例）。43例心包继发癌占53%，淋巴瘤占21%。40例（第3组）有心包积液（75%为慢性），其中28%为特发性，23%为心包切开术后积液。33例（第4组）临床表现为急性或复发性心包炎，其中特发性心包炎占70%。最后，32例患者（第5组）因与原发性心包疾病无关的疾病行心包切除术。总之，心包狭窄倾向于非结核性（100%）、非肉芽肿性（96%）、特发性或医源性（90%）和非钙化性（64%），并且可发生于正常心包厚度（4%）。由于非钙化性心包缩窄（第1组）、心包积液（第3组）和心包炎（第4组）病例的大体和显微镜特征存在相当大的重叠，因此需要临床信息来提供准确的临床病理学解释。(C)2001 Elsevier Science Inc. All rights reserved.
Among 344 cases with surgically resected parietal pericardium, ages ranged from 1 to 87 years (mean, 55), and 64% were male. Causes of pericardial disease included neoplastic (33%), idiopathic (30%), iatrogenic (23%), and others (14%). Pericardial constriction (Group 1) represented the largest group (143 cases, 76% male). Maximal pericardial thickness was 1-17 mm (mean, 4). Fibrotic thickening occurred in 96%. Chronic lymphoplasmacytic inflammation affected 73% (mild or moderate in 97%). Calcification was uncommon (gross in 28%, microscopic in 8%), and granulomas were rare (4%, none tubercular). Constriction was idiopathic in 49% and iatrogenic (postpericardiotomy or postirradiation) in 41%. Neoplasms and cysts (Group 2) represented the second largest group (96 cases). Among 43 cases with secondary pericardial involvement, carcinomas accounted for 53% and lymphomas 21%. Forty cases (Group 3) had pericardial effusions (75% chronic), which were idiopathic in 28% and postpericardiotomy in 23%. Thirty-three cases (Group 4) had acute or recurrent pericarditis clinically, which was idiopathic in 70%. Lastly, 32 cases (Group 5) had pericardial resection for conditions unrelated to primary pericardial disease. In conclusion, pericardial constriction tended to be nontubercular (100%), nongranulomatous (96%), idiopathic or iatrogenic (90%), and noncalcific (64%), and it could occur with normal pericardial thickness (4%). Because considerable overlap in the gross and microscopic features existed among cases with noncalcific pericardial constriction (Group 1), pericardial effusions (Group 3), and pericarditis (Group 4), clinical information was necessary to provide an accurate clinicopathologic interpretation. (C) 2001 Elsevier Science Inc. All rights reserved.